NPI | 1891300323 |
---|---|
Former Name | THALIA DELACRUZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: MA RN2385047) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MA LN97053) |
Enumeration Date | 2020-09-11 |
Last Update Date | 2024-02-09 |